Significance of Radiofrequency Ablation for Unresectable Colorectal Cancer With Liver Metastases

Tago, Tomoya; Katsumata, Kenji; Udou, Ryutaro; Kasahara, Kenta; Mazaki, Junichi; Kuwabara, Hiroshi; Enomoto, Masanobu; Ishizaki, Tetsuo; Nagakawa, Yuichi; Sugimoto, Katsutoshi; Tsuchida, Akihiko

doi:10.21873/anticanres.15367

Cited by 11 publications

(8 citation statements)

References 22 publications

(25 reference statements)

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“…SRT is a specialized radiotherapeutic modality employing precisely focused radiation beams directed at locoregional lesions, while minimizing the involvement of adjacent normal structures [ 15 ]. RFA is a minimally invasive technique applying heat energy in the form of radio waves to eliminate cancer cells within the liver [ 16 ]. LDT was applied to patients with LM of EC only when it was deemed to be potentially beneficial in terms of survival or palliation after multidisciplinary consultations including clinical oncologists, radiologists, gastroenterologists, and hepatic surgeons.…”

Section: Methodsmentioning

confidence: 99%

Implications of Liver-Directed Therapy for Postoperative Hepatic Metastasis from Esophageal Cancer

et al. 2022

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Background: Distant recurrence of esophageal cancer (EC), even after radical resection, is common, and the most frequent site of EC metastasis is the liver. However, a multidisciplinary treatment strategy for postoperative liver metastasis (LM) from EC has yet to be established; in particular, the role of liver-directed therapy (LDT) remains uncertain. We investigated the clinicopathological features and outcomes of patients undergoing post-esophagectomy LM with versus without LDT to explore its therapeutic implications. Methods: Among 624 consecutive patients undergoing R0/R1 esophagectomy for EC, 30 were identified in whom LM had developed as the initial recurrence. Their characteristics were retrospectively reviewed. Results: Six of the 30 subjects underwent LDT for metachronous LM. Five of those 6 also received systemic chemotherapy. A comparison between the 6 LDT and 24 non-LDT cases revealed no significant differences in major clinicopathological and operative factors, except for concurrent metastasis to extrahepatic organs (1/6 vs. 15/24, p=0.044). Twenty-nine of the 30 patients died during the study period, whereas 1 who had received multimodal treatment with LDT remained alive more than 200 months after multiple LM had been detected. Kaplan-Meier analysis for survival after LM demonstrated significantly prolonged survival in LDT cases compared to non-LDT cases treated with systemic chemotherapy alone (p=0.014). Even when the analysis was limited to patients without extrahepatic metastasis, this significant prognostic advantage of LDT was maintained (p=0.047). Conclusion: Multimodal treatment combined with LDT might be beneficial for patients with metachronous LM from EC and should therefore be considered a potential treatment option.

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Section: Methodsmentioning

confidence: 99%

Implications of Liver-Directed Therapy for Postoperative Hepatic Metastasis from Esophageal Cancer

et al. 2022

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Section: Comparison With Surgical Metastasectomy and Radiation Therapymentioning

confidence: 99%

“…Tago et al compared the prognosis between 92 patients undergoing surgery for CRLM and 26 patients undergoing RFA for unresectable CRLM [ 46 ]. The median OS was 49.5 and 44.9 months in the surgery and RFA groups, respectively, and was significantly shorter in the RFA group [ 46 ]. However, this result could be attributed to the different patient backgrounds between the two groups; the number of liver metastases and extrahepatic metastases were significantly larger in the RFA group, and only unresectable tumors were treated by RFA.…”

Section: Comparison With Surgical Metastasectomy and Radiation Therapymentioning

confidence: 99%

Evidence on percutaneous radiofrequency and microwave ablation for liver metastases over the last decade

et al. 2022

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Purpose This review aimed to summarize the treatment outcomes of percutaneous radiofrequency ablation (RFA) and microwave ablation (MWA) for metastatic liver tumors based on the findings of published studies over the last decade. Materials and methods Literature describing the survival outcomes of ablation therapy for liver metastases was explored using the PubMed database on April 26, 2022, and articles published in 2012 or later were selected. The included studies met the following criteria: (i) English literature, (ii) original clinical studies, and (iii) literature describing overall survival (OS) of thermal ablation for metastatic liver tumors. All case reports and cohort studies with fewer than 20 patients and those that evaluated ablation for palliative purposes were excluded. Results RFA was the most commonly used method for ablation, while MWA was used in several recent studies. RFA and MWA for liver metastases from various primary tumors have been reported; however, majority of the studies focused on colorectal cancer. The local control rate by RFA and MWA varied widely among the studies, ranging approximately 50–90%. Five-year survival rates of 20–60% have been reported following ablation for colorectal liver metastases by a number of studies, and several reports of 10-year survival rates were also noted. Conclusion Comparative studies of local therapies for colorectal liver metastases demonstrated that RFA provides comparable survival outcomes to surgical metastasectomy and stereotactic body radiation therapy.

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“…The liver is one of the most common metastatic sites of advanced solid tumors (1)(2)(3)(4). Hematological metastasis is the main cause of liver metastasis in colorectal cancer.…”

Section: Introductionmentioning

confidence: 99%

Clinical significance and changes to the immune microenvironment of colorectal cancer patients with liver metastasis

Wang¹,

Tang²,

Ouyang³

et al. 2023

J Gastrointest Oncol

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Background: Liver metastasis is common in colorectal cancer patients. Immunotherapy covers a wide range of tumor types and is safer than traditional radiotherapy and chemotherapy. However, its overall effective rate is only 20-40%. At present, there is a lack of relevant research clarifying whether the changes and clinical significance of the immune microenvironment in colorectal cancer patients with liver metastasis are conducive to enhancing the promotion and further improving the efficacy of immunotherapy. Methods:We retrospectively collected the data of 50 colorectal cancer patients with liver metastasis treated in Chongqing University Cancer Hospital from January 2017 to January 2019. Liver metastatic cancer tissues and normal liver tissues were collected to detect the levels of immune cells in the two samples. At the same time, the correlation between T-cell subsets in the liver metastatic cancer tissue immune microenvironments of colorectal cancer patients and prognosis was analyzed.Results: Compared with the normal liver tissues, the level of T helper cell 1/T helper cell 2 (Th1/Th2) in the liver metastatic cancer tissues was significantly decreased (0.88±0.24 vs. 1.34±0.27, P=0.000), while the levels of regulatory T cells were markedly increased (8.57±2.31 vs. 6.89±1.71, P=0.000). The Th1/Th2 level in liver metastatic cancer tissue exhibited a good predictive value for recurrence and survival 3 years after surgery, and the areas under the curves were 0.783 (95% confidence interval: 0.649-0.916, P=0.002) and 0.763 (95% confidence interval: 0.628-0.898, P=0.001), respectively. Moreover, the regulatory T-cell level in liver metastatic cancer tissue had a good predictive value for recurrence and survival at 3 years postoperatively, and the areas under the curves were 0.788 (95% confidence interval: 0.656-0.919, P=0.002) and 0.763 (95% confidence interval: 0.628-0.897, P=0.001), respectively. Conclusions:The immunosuppressive condition of liver metastasis in colorectal cancer patients was related to poor prognosis.

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Significance of Radiofrequency Ablation for Unresectable Colorectal Cancer With Liver Metastases

Cited by 11 publications

References 22 publications

Implications of Liver-Directed Therapy for Postoperative Hepatic Metastasis from Esophageal Cancer

Implications of Liver-Directed Therapy for Postoperative Hepatic Metastasis from Esophageal Cancer

Evidence on percutaneous radiofrequency and microwave ablation for liver metastases over the last decade

Clinical significance and changes to the immune microenvironment of colorectal cancer patients with liver metastasis

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